Mangus Richard S, Tector A Joseph, Agarwal Avinash, Vianna Rodrigo, Murdock Phillip, Fridell Jonathan A
Department of Surgery, Transplantation Section, Indiana University School of Medicine, Indianapolis, IN 46202-5250, USA.
Liver Transpl. 2006 Feb;12(2):226-30. doi: 10.1002/lt.20552.
Histidine-tryptophan-ketoglutarate solution (HTK) and University of Wisconsin solution (UW) have been shown to have similar outcomes in cadaveric kidney, pancreas, and liver transplantation. Our institution changed from UW to HTK as the primary preservation solution for liver, kidney and pancreas transplantation. This study compares the perioperative and first year outcomes of liver transplantation using UW or HTK. Primary use of HTK began on May 1, 2003. We reviewed the records of all adult liver transplant recipients from July 1, 2002 to December 31, 2004. Recipients were compared based on organ preservation solution (UW n = 204, HTK n = 174). Outcomes included 1-, 6- and 12-month graft and patient survival and 1-, 7-, 14-, and 30-day liver function and serum creatinine. During the entire study period, the two groups were managed similarly in operative technique, immunosuppressive regimens, and donor liver criteria. Over 30 months, 378 adult patients underwent liver transplantation. There were no significant differences between UW and HTK in 1-, 6-, or 12-month graft or patient survival. The HTK group had a higher day 1 median AST, ALT, and total bilirubin, but the two groups were similar thereafter. An anticipated difference in infused volume between UW and HTK was demonstrated. In conclusion, to our knowledge, this is the first reported large case series from North America comparing HTK and UW in liver transplantation with 2- to 12-month follow-up. There were no significant differences between HTK and UW in this population when comparing 1 month graft function and first-year graft and patient survival.
已证实，组氨酸 - 色氨酸 - 酮戊二酸溶液（HTK）与威斯康星大学溶液（UW）在尸体肾、胰腺和肝移植中具有相似的效果。我们机构已从UW改为HTK作为肝、肾和胰腺移植的主要保存溶液。本研究比较了使用UW或HTK进行肝移植的围手术期及第一年的结果。HTK的首次使用始于2003年5月1日。我们回顾了2002年7月1日至2004年12月31日所有成年肝移植受者的记录。根据器官保存溶液对受者进行比较（UW组n = 204，HTK组n = 174）。结果包括1个月、6个月和12个月时的移植物和患者存活率，以及1天、7天、14天和30天时的肝功能和血清肌酐。在整个研究期间，两组在手术技术、免疫抑制方案和供肝标准方面的管理相似。在30多个月的时间里，378名成年患者接受了肝移植。UW组和HTK组在1个月、6个月或12个月时的移植物或患者存活率方面没有显著差异。HTK组第1天的AST、ALT和总胆红素中位数较高，但此后两组相似。UW和HTK之间在输注量上存在预期差异。总之，据我们所知，这是北美首次报道的比较HTK和UW在肝移植中进行2至12个月随访的大型病例系列。在比较1个月移植物功能以及第一年移植物和患者存活率时，该人群中HTK和UW之间没有显著差异。
